Prevalence and Phylogenetic Variant of Gbv-C on Disease Progression of Hcv, Hbv and Hiv Under Haart
No Thumbnail Available
Date
2019-04-03
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Addis Ababa University
Abstract
Despite the advancements in health system management and technology, Human
Immunodeficiency Virus (HIV), Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) remain a
serious global public health challenge. GB virus (GBV-C) is a virus in the Flaviviridae family
with HCV that was isolated from patients with liver disease. It has the same mode of transmission
with HIV, HBV and HCV. Several studies from different countries have reported the positive role
of GBV-C in improving the clinical infection and treatment outcomes of HIV patients, while its
impact among HBV and HCV patients is controversy. Although the virus has been isolated from
patients with fulminant hepatitis, but other studies failed to prove any association. Co-infection of
GBV-C with one or more hepatotropic viruses like HBV or HCV may have negative or positive
effect on the disease evolution. In Ethiopia, there has not been any study made on the prevalence
or the clinical impact of GBV-C in circulation. Therefore, the aim of this study was to determine
the prevalence, predominant genotype and the association between GBV-C and the clinical
outcome among viral hepatitis and HIV patients under HAART.
Serum samples were collected from different population living in Addis Ababa from March 2014
to February 2016. The subjects of this study comprised a total of 252 participants of all ages, and
were divided into distinct groups according to their health status. The first group comprised a
total of 81 HIV samples that were sent to the health research laboratory in Addis Ababa for
follow-up studies, the second group comprised a total of 101 serum frozen samples collected
from Adera Internal Medical Specialty Center for patients with viral hepatitis, and 70 frozen
serum samples of healthy individuals collected from the Ethiopian Public Health and Research
Institutes and adult volunteers. To determine the prevalence of GBV-C, RNA was extracted,
reversed transcribed, and amplified by Real Time polymerase chain reaction (PCR), using
primers for 5- untranslated region (5-UTR) of the HGV/GBV-C. Among the HIV patients the
CD4+ cells count and plasma viral load were performed. Liver function test and abdominal ultra
sound were investigated in all viral hepatitis patients. The prevalence of GBV-C RNA were
detected in 20 (11.27%) of the patients with viral hepatitis and HIV, while all the healthy subjects
were negatives.
Among HIV patient’s comparison of the mean CD4+ count was found to be significantly
different between HGV/GBV-C positive and negative patients at (P < 0.05). GBV-C and HIV
coinfected patients were categorized in the first and second WHO clinical staging system.
Furthermore, positive and negative GBV-C patients were sub divided into small groups based on
age, sex and date of starting HAART. The number of CD4+ cells over time increased more
rapidly in GBV-C positive patients compared to GBV-C negative patients. Among viral hepatitis
patients the prevalence of GBV-C were slightly higher among HBV patients, however, there was
no significant difference (P > 0.05) in the liver enzymes level among GBV-C negative and
positive individuals. Our study found that GBV-C infection had no influence on the severity of
chronic liver disease among HBV and HCV coinfection. While among HIV patients the
vi
coinfection reduces the viral load, increases the number of CD4+ cells and improves response to
treatment.
To determine the predominant genotype, serum samples were recollected on 2017, from the same
patients who were GBV-C positive in 2014. After performing various molecular techniques on
the samples, the virus was detected but at a low level in the patient’s serum, which indicates the
clearance of the virus. Therefore it was not possible to sequence the virus.
To the best of our knowledge, this is the first report of GBV-C in Ethiopia. Understanding the
mechanisms between GBV-C and HIV could lead to develop novel treatment/vaccine.
Description
Keywords
Prevalence, Phylogenetic Variant, GBV-C, Disease Progression, HCV, HBV and HIV Under HAART